Non-surgical heat procedure tames reflux

May 19, 2002|By Robyn Suriano. Special to the Tribune. Robyn Suriano is a staff writer for the Orlando Sentinel, a Tribune newspaper.

ORLANDO — Chocolate was the worst. The sweet stuff instantly transformed Sherri Loughlin's stomach into a bubbling cauldron that overflowed with acid.

The fluid would splash back into her esophagus, creating the uncomfortable and common condition called gastroesophageal reflux disease. After living with it for more than 20 years, Loughlin, 39, recently underwent a new procedure that has relieved her chronic heartburn.

Her doctor applied heat to the tissue in her lower esophagus, causing the tube to tighten and prevent stomach acids from spilling back into the esophagus. The procedure, called Stretta, has shown promising results in studies so far.

If it proves effective with further use, doctors think Stretta could become a widely used alternative to the expensive medications and more invasive surgery currently used to treat reflux disease.

"It's really worked well for me," said Loughlin of Celebration, Fla., a drug manager for a grocery store. "I was weaned off my medications in the month after my procedure, and I'm fine now. I can eat all the spicy foods I want."

About 14 million Americans suffer from gastroesophageal reflux disease, which can occur in people of any age and remain a lifelong problem.

Doctors say many things contribute to reflux disease, including diets that are rich in fatty foods, eating right before going to sleep and consuming too much caffeine.

Many people with reflux disease get the burning sensation in their chest commonly described as heartburn.

If not controlled, the condition can lead to more serious problems, said Dr. Badar Anwer, a gastroenterologist at Florida Hospital's Celebration Health. If the tissue of the esophagus is continually exposed to stomach acids, it can undergo changes that make it more susceptible to esophageal cancer.

Most people can control reflux by changing their diets and taking over-the-counter or prescription medications. But some people do not want to take medication for the rest of their lives, and some don't get enough relief with even the best drugs.

They may be candidates for Stretta, which is being performed by about 150 doctors nationwide for about 2,000 total procedures to date, according to Curon Medical Inc. of Sunnyvale, Calif., which developed the procedure.

In the procedure, doctors pass a tube into the patient's mouth and down to the lower end of the esophagus, which leads into the stomach. Radio-frequency energy, which feels like heat to the tissue, is released through the tube in tiny doses along the circumference of the tube.

"You're literally burning the skin," said Dr. Nasir Alar, a gastroenterologist with Health Central Hospital in Ocoee, Fla., who plans to offer the procedure in the future. "It causes the collagen fiber in the skin to contract, and it kind of tightens up your lower esophagus."

The process takes about an hour. Stretta is done in the hospital as an outpatient procedure. Possible short-term complications include bleeding and chest pain that recedes in a few days.

In studies, Stretta helped the majority of patients, with 70 percent being able to discontinue all heartburn medications and eliminating regurgitation in 55 percent of people. Up to one year afterward, no significant bad reactions were discovered.

Even so, doctors say, more time is needed before they can envision this option being used widely.

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About 15 locations in northern Illinois use the Stretta procedure. Patients wanting to find such a hospital or clinic can visit the Curon Medical Inc. Web site at www.curon-medical.com or call the customer service line at 877-734-2873.